Vaginal Candidiasis

    This is usually caused by the species of fungus called Candida. There are various organisms belonging to this group including Candida albicans, Candida tropicalis and Candida glabrata. However, about 70% of all infections are known to be caused by Candida albicans. 
   Infection is usually more prevalent in pregnant than in non-pregnant women. Though, it is not primarily a sexually transmitted infection, it can be transmitted sexually and the practice of anal sex has been reported to increase the risk of infection since the organism is prevalent in the gut. It also occurs after a course of broad spectrum antibiotics.It is very prevalent in persons with depressed immunity, hence it is most often found in diabetic patients, HIV-infected patients, patients on long-term steroid or immunosuppressive therapy and persons on oral contraceptives.
   Persons with vaginal candidiasis usually complain of pruritus(itching) in the vulva and vagina and soreness of the vagina. There may be burning pain and dyspareunia(pain during coitus). Usually, there is a thick white or yellowish vaginal discharge. The discharge which is cheasy, may form plaques on the vaginal wall. Similar plaques may be seen in the buccal mucosa(walls of the mouth). This is referred to as oral thrush and is usually seen in infants who have been infected by their mothers. In some persons, infections may be symptomless while in others, symtoms may be recurrent.
   The diagnosis may be obvious from the symptoms and signs. However, confirmation is through microscopic examination of the discharge. Unfortunately, this may identify only 60% to 70% of infections. Treatment involves the use of antifungal topical agents. Oral medications may also be used but these should not be given to pregnant women. Vaginal tablets(inserted in the vagina) may be useful for patients with profuse discharge. Patients with recurrent infections should have their partners investigated and treated if found positive.